摘要
目的:探讨螺内酯对1~3期慢性肾脏病(CKD)患者尿蛋白、醛固酮及肌酐水平的影响。方法:80例使用血管紧张素转化酶抑制剂(ACEI)和(或)血管紧张素受体拮抗剂(ARB)的1~3期CKD患者随机分为4组,A组给予贝那普利,B组给予贝那普利及厄贝沙坦,C组给予贝那普利及螺内酯,D组给予贝那普利、厄贝沙坦及螺内酯组,比较4组患者治疗前及治疗第2、4、6月时尿蛋白下降百分比、血浆醛固酮、血肌酐、血压、血钾水平,分析治疗前及治疗后6月时24 h尿蛋白与醛固酮的相关性。结果:治疗后第4、6月,C、D组24 h尿蛋白下降百分比高于A、B组,血浆醛固酮水平低于A、B组,差异有统计学意义(P<0.05);各时点各组CKD患者血肌酐、血压、血钾水平差异无统计学意义(P>0.05);尿蛋白与血浆醛固酮水平呈正相关(P<0.05)。结论:在ACEI和(或)ARB治疗基础上加用螺内酯可减轻1~3期CKD患者尿蛋白,可能延缓CKD进展。
Objective： To investigate the effect of spironolactone on the levels of urine protein,aldosterone and creatinine in patients with 1 ~ 3 stage chronic kidney disease（ CKD）. Method： Eighty patients with early CKD who cured by ACEI or ARB were divided them into 4 groups randomly,group A was treated with benazepril,group B was given benazepril and irbesartan,C group was given benazepril and spironolactone,group D was given benazepril,irbesartan and spironolactone. The percentage of urine protein decrease,plasma aldosterone,blood creatinine,blood pressure and blood potassium level were compared between the 4 groups before treatment and second,fourth,sixth months after treatment. The correlation between 24 h urine protein and aldosterone before and sixth months after treatment was analyzed. Results： After treatment for 4 and 6 months,the percentage of urine protein decrease in groups C and D was higher than that of groups A and B,plasma aldosterone levels were lower than groups A and B,the difference was statistically significant（ P〈 0. 05）; no statistical difference was found in serum creatinine,blood pressure,blood potassium levels at each time point in each group of CKD patients（ P〉 0. 05）; urinary protein was positively correlated with the level of plasma aldosterone（ P〈 0. 05）. Conclusions： In CKD 1-3 stage patients,adding spironolactone can reduce urinary protein on the basis of ACEI and ARB,and delay the progress of CKD.
作者
董晓
曾家顺
DONC Xiao1, ZENG Jiashun2(1. Guizhou Medical University, Guiyang 550004, Guizhou, China ; 2. Affilited Hosptial of Guizhou Medical University, Guiyang 550004, Guizhou, Chin)
出处
《贵州医科大学学报》
CAS
2018年第3期329-335,共7页
Journal of Guizhou Medical University
基金
贵州省卫生计生委科技术基金项目(gzwjkj2014-2-108)
关键词
螺内酯
慢性肾脏病
24
h尿蛋白
醛固酮
血肌酐
血钾
spironolactone
chronic kidney disease
24 h urinary protein
aldosterone
serum creatinine
serum potassium
